Birth, Baby!

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Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a Birth Dula, Hypnobirthing Educator, and Pediatric Sleep Consultant.

Samantha is a Birth Dula, Childbirth Educator, and Lactation Counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

Today, we are on with Gayle with Matrescence Occupational Therapy.

I hope I say that right.

I always feel like maybe I don't.

She is here to talk with us today about what the heck occupational therapy even is and how to put those motherhood pieces together.

And they are so good at helping with that.

So thank you so much for being here today, Gayle.

Thanks so much for having me.

So can you start us off by just kind of telling us what is like the broad definition of occupational therapy?

What is occupational therapy?

Sure.

So it's definitely not finding people jobs because that's what people think of when they think of occupation.

So good, I never heard that one.

So yeah, we don't find people jobs, but we look at the things that occupy your time.

So if you think of occupational in that way, so we look at using everyday life activities to promote health, wellbeing and participation in the things that matter to you.

So participation means like, okay, going to work, going to school, taking care of your own hygiene, taking care of your family.

So it's pretty broad, like you said, but also it can be very generalized.

You might see OT in various settings, like in schools or in the hospital or in like nursing homes and things like that, but never in this field with maternal health.

Yeah, it's pretty unique because I remember the first time I ever heard the words occupational therapy was they were recommending that I take my daughter to it because she had so many sensory issues with, she don't want to wear jeans, even leggings had to make sure they didn't have seams certain places, shirts couldn't be a certain way, socks couldn't be a certain way.

And that was the first time I ever heard of it.

And actually we worked through those issues.

Well, I say that she still wears $15 a pair of socks because she doesn't want seams and she's 13.

But we never went because I also really didn't understand what it was and all they said was she needed it.

And I never knew really what that meant.

So for those, I mean, everyone listening, you wouldn't know that Gayle and I actually got to talk with Jessica, the other owner of this practice.

And Sam was at a birth that day, so she didn't get to join us.

But it was so eye-opening to me when we had our conversation where I was kind of learning how you could help families that we work with.

And I was like, oh my gosh, we have to have you on the podcast to help understand what this is.

Because once we started talking about it, I was like, so many people could benefit from this.

So how did you guys get into this area of serving prenatal and postpartum demographic?

Like you just said, it's kind of unique.

Right, it's a niche practice area right now.

So in the occupational therapy world, maternal health OT is becoming bigger and bigger.

And we're super excited for that shift to happen.

But how we both got into it, so Jessica and I met at a local hospital where we worked with adults in the hospital setting.

She herself has two daughters, a five-year-old and a seven-year-old.

And I birthed my daughter during the pandemic.

And so around that time is when we were both kind of feeling, I mean, you know, the world went crazy.

So she was like, how am I going to manage all these kids at home, be a parent, be a teacher, be a, you know, all the things.

And I was like, do I want to go back to this field in the hospital where everybody's really sick and, you know, insurance is going crazy and all these things.

And we were having our own lived experience of being a mother.

And with our occupational therapy training, it's like, we need to be in this space.

You know, we look at things in, one, the big picture.

We look at our patients' and clients' environment and how that affects their every day.

We look at mental health and we put the pieces together.

So we got into this niche by our limited experience and wishing we had the kind of support that we are looking to offer moms today.

That's awesome.

Yeah, I mean, I think that that whole person kind of holistic approach is so important and we don't really see that a whole lot in maternal health care, but I think people are starting to see more of the need for that and how it can really help people.

So now that we kind of understand what Occupational Therapy is, how does it actually look when you're serving people in this stage of life?

Motherhood in itself is a developmental milestone, right?

We don't look at it that way.

We look at birth, we have the baby, they turn into a toddler, they're walking, they're doing all the things.

Now they go to school, the whole transition and then you become elderly, you go to college, all these things, but motherhood is a huge transition.

And that is what matrescence actually means.

It's the transition into motherhood, much like adolescence, which is becoming an adult.

So it's a physiological, emotional, social, all the big changes that are happening in your life.

And it's more, I mean, it happens every time you have a child too, it's not just the first time.

So what we look at when we're serving this population is, well, what's happening in this transition?

How is it affecting your day to day that now you're not functioning at your optimal level?

I guess you could say.

We definitely would love to start working with mothers prenatally.

We can start that education in conjunction with what you all as doulas do, right?

Because we don't want to do what you guys do.

You guys do so many other things that we're like, okay, that's your thing.

We want to kind of empower moms to like focus on what's going to happen when you guys aren't there, right?

And what is the future going to look like with the mental health piece and even relationships with their partners and their family members and creating boundaries.

So another thing that we like to talk about is like life hacking, right?

Because when you think about how we adapt the environment or adapt the task.

So for example, breastfeeding or nursing, we may set up your physical environment with pillows, right?

So that you're not having back, shoulder, neck pain in those positions that you're in for 25, 30 minutes at a time, maybe overnight and you're half asleep.

We want to build things into your routine so that you don't have to think about it anymore and it's less stressful, especially in that early motherhood phase when you are in survival mode, right?

You all know, you've seen them in this, like in the depth where they're basically zombies.

So we do that by practicing or working through those daily activities.

So like I said, in occupational therapy, we do it, we treat or we have our interventions by doing.

So if breastfeeding is the issue, well, let's look at what the breastfeeding issue is.

I mean, along with Latch, Jessica is now a CLC, so it's really awesome.

She can really focus on the Latch and any pain that's going on with mom.

But again, big picture also, the routine of it.

And what is it gonna look like in the middle of the night or with partner?

Like partner's gonna come and maybe bring baby to mom, which I know you guys do too, right?

In the postpartum doula stage.

Yeah, postpartum doulas do that.

Like overnight for sure, yeah.

Yeah, and so we would in conjunction with y'all teaching them that, then we look at, okay, but how does that look in dad's daily routine, right?

So what does he need to adapt in his day to day?

Like maybe he needs to shift a couple things in his day schedule in order for that to work with mom.

And we do a thing called activity analysis, which is, you know, really fancy term of just like looking at what needs to be done and breaking down each specific task for that item and figure out how to like make it ideal for the patient.

Does that make sense?

Yeah, I think that's so important too, that you talk to the partner about how to implement it, because we always, you know, we tell them what needs to be done, but how to get there is sometimes we kind of forget that that doesn't come naturally to everyone.

It doesn't, they're not able to think about what I need to shift in my day to make that happen.

Some dads might just be like, or other mom or whatever.

Well, I have meetings every day at this time and I can't whatever, or I don't get off until this time.

Well, if you were to shift something else in your day, maybe you could, and they don't have that wide view picture.

And then they just are like, sorry, but it sounds impossible.

I would love to do it, but I just can't.

And having that other person who one is well rested, because you're well rested, and they are not at the point, be able to break that down and really sift through it together to figure it out.

That is the missing link in so many people's experience.

And that's just one example of that missing link.

And I think that was the thing that when we talked, when we first met, that was the thing that really was so cool to me, because you guys were saying how, you know, you do have mental health ground of being able to help people with those things.

Now, Jessica is going through her lactation certification.

There are other things that you guys know how to do.

And so I think one of our big questions, or at least in the beginning was, do most people that work with you have other providers they're working with for things, or do you guys do all of those things?

And I think you kind of just answered that, right?

You're being the middle ground of pulling all of those pieces together.

And what I really loved when we talked is I don't remember who came up with it, but I was explaining how as postpartum doulas, we often say, we want to be the scaffolding.

We want to be the scaffolding so that as you're building the building, you're able to get there and get it done, but then we take the scaffolding away and then the building stands on its own.

And you guys are like, yeah, that's kind of what we do, but we have to bring in all the extra pieces that people didn't know, right?

Do you remember that?

Yeah.

Yeah, and then we were talking about us being the grout, right?

So if we have the pediatric dentist and we have the lactation consultant and we have craniosacral therapy and everybody's doing such amazing work together, but then sometimes the families come home and they're like, well, now what?

How do we put that together in our routine, in our day-to-day?

So we smooth it over with the grout and we're like, okay, well, can you shift this around?

Can you look at maybe moving this appointment or maybe we can combine things together?

And like you said, when you're sleep deprived and you're only seeing because you have this like really, what is it called?

When you're like-

The narrow vision, like tunnel vision.

Yeah, tunnel vision, thank you.

We kind of like widen that focus for you again to kind of see like, well, it's going to be okay.

Sucks right now, you know, you're stressing about all these things.

But when you talk about the other providers too, like one of our values is connection.

So that includes it within the family, but also with other providers.

We want to contribute to that village that we all are so desperately seeking, right?

So we, there's, you know, if someone comes to us and they are already working with someone, that's great.

But then we also see people who aren't working with anyone and they're like, I don't know what to do.

Well, of course we would refer out when it's out of our scope or out of our, you know, experience.

And then we bring teams together.

That's this collaborative approach that we do so well in the hospital setting because we're all right there, right?

We'll just like hop over to PT and speech therapists and be like, hey, what should we do with this patient?

In the community, it doesn't happen as much because we're so siloed out.

We, you know, we're so far away from each other, but definitely in this birthing space, I mean, we love having connected with all of you at all the events.

I just think that, you know, being able to be connected is just really gonna serve our client base well.

Yeah, it can be really overwhelming.

And I think that that is the big piece here that, and I'm gonna go devil's advocate here for a second.

I know some people are like, we've done this for centuries and millions and millions of years.

Like people can figure this out.

Come on, like you don't need all of these people, all of these appointments, just back to the basics, be in bed with your baby, nurse, don't have any interruptions.

Yeah, that's really cool when you have a village.

That's really cool in other countries, besides the United States.

A lot of them have that, where people come in in the community and they're making sure that you don't have to get out of bed and they're helping with your other kids and they're making food for you.

And you have elders in your village that are able to help with breastfeeding because they've dealt with breastfeeding issues.

But that is not the community that we live in anymore.

So I just, for the naysayers, because I think that's where a lot of our minds tend to go automatically is like, this is kind of silly, you guys.

This is a little much.

But we need that now, unfortunately.

We've built such a culture of I can do it myself, I can do it myself.

And in parenthood and in motherhood specifically, that doesn't work.

You need that village.

And so we have kind of created in the United States this culture of like, well, I have my OB and I have myself and that's kind of it.

Like I can figure everything out on my own and that's just, it really doesn't work that way.

And so that's where some of these other professionals like you and like us and so many others in the birth community and postpartum community really come into play.

We had a talk with Rue, the boob boss.

I don't know if that will have come out by the time this episode airs.

I think it will have.

And she says, well, now we have to pay for our village.

I think that's who said it.

We do.

We kind of have to pay for our village now.

I might be giving her credit for something she didn't say, but I think it was her.

So yeah, it's really, that's a difficult scenario, but that is where we find ourselves.

And there's pros and cons to that too, right?

Like we're trained.

We go through a lot of training to be the part of the village that we are in.

We do a lot of research.

We're very specialized.

You were very specialized in what you do.

We are very specialized in what we do.

And that brings its own pros.

I think, yeah, we have to pay for it and that kind of sucks.

But you know, for her.

I think that that's the same thing with postpartum doula support.

You know, Jess, one of our postpartum doulas, she always says, but I don't get my feelings hurt if you don't follow my advice.

And your mom, your sister, your mother-in-law, your aunt, your grandmother, they're all gonna be like, I've done this before and I raised you just fine.

Like, why aren't you taking my advice?

And you're like, yeah, well, you got your turn.

And now it's my turn.

So that is one of the benefits of hiring your village is, you know, you don't have to worry about the emotional piece that they're gonna, you know, you know, they have a vested interest, but it's not like this emotional piece where, hey, didn't you follow what I said?

Yeah.

Exactly.

We've seen that with some of the moms who were working with starting solids.

And, you know, they wanted to go with the baby-led weaning approach, the family did.

And then of course, grandparents wanna do a spoon fed and all this stuff.

And I was like, tell them, your therapist told you that these are the strategies that we're working on and make me the bad guy.

It's totally fine.

You don't have to fight that battle because we wanna be here for what's meaningful for you.

And if that's not meaningful for the grandparents at the time, then sorry, you know, that's exactly it.

We can be the bad guys in this situation.

Yeah, we do that too.

We're like, just blame your doula.

Tell them that your doula said, sorry, like we shouldn't have more than her and my partner in the birth space.

And statistically, it makes XYZ.

And look, we're just blame us.

I played that card on Saturday at the birth that I was at.

I was like, you know what?

If they want to come in, you just tell them your doula said no, said that you can't, I'm sorry.

And that you can roll with it.

And then we had some conversations with the nurse afterwards and they were like, okay, we're just gonna say, we're gonna have a code word.

And when we're done with the family, we're gonna drop the code word and the nurse is gonna come in and be the bad cop and kick everybody out.

And that's awesome.

It's a great way to do it sometimes.

So how would someone figure out if they need y'all?

And is this helpful for everyone or just like certain people?

Of course, I would say occupational therapy is for everyone, right?

I mean, but it also depends on the means.

But honestly, if we could get an OT in probably every single industry, there may be less problems.

That's just a, you know, I love, I mean, I love OT that much.

But to figure out if they would need us, I would say if they think they're having a problem with something and they're not sure who they should go to, they can always get a free consult with us.

We offer free 30 minute consultations.

And like I said, we can like do like mini brainstorming during the session, see if we're a good fit to work with them and if our services are helpful for them.

And otherwise we could refer them out.

Or if they are seeing self-help providers, like I mentioned before, you know, baby is seeing a pediatric PT, maybe there's a craniosacral therapist involved, maybe there's a lactation consultant involved.

And for some reason, like things are still not working or mom's mental health is still struggling with all of those tools in her toolbox.

Again, free consultation, we'll work through it and then we'll figure things out.

I don't know if I talked about it before, but yes, we are a maternal health OT practice, but we definitely focus on the dyad, so mom and baby, because clearly we know that in this space, what's happening with baby is very closely related to what's happening with mom.

So we talk a lot about co-regulation and co-occupations.

So feeding is baby being fed, but mom is feeding.

Sleep often is the same way too, whether it be co-sleeping or sleeping right next to each other, it's so intertwined.

And so I mentioned sleep feeding, toileting even, so like mom, parent changing diapers, like these are all what we call ADLs or activities of daily living.

So they're very intertwined at this phase.

And we see clients through baby's first year and it's like the entire family that we're working with.

That's so huge.

I was just talking to somebody, it was my dad actually, this is one of his hills to die on that he really feels like partners often get kind of left behind in the pregnancy and birth and postpartum.

And he feels so strongly that dads need to be kind of be brought back into the picture and be part of all of these things so that they can also be getting the help because they want to be involved too.

And I love that you guys are doing that.

Absolutely.

I have to brag on my husband a little bit because he has been such an amazing partner throughout all of this.

And I think it really helped that our postpartum nurse, when we walked into the room after delivery and everything, I had a C-section, but when we got into the postpartum wing, there was already a list on the board, dad's job is like check on baby, unswaddle, check the diaper, you know, and then give to mom, mom will feed, you take baby back, check the diaper again, reswaddle, put her in the bassinet.

And so that is what he did the whole way through because he was told exactly, it was huge.

Exactly.

And you know, I hear from so many of my friends and stuff and they like come home with the baby and they're like, what am I supposed to do?

You know, and luckily, you know, as doulas and other birth educators, they're providing this education, but not everyone gets it.

And we know that's, you know, that happens.

But can you imagine a world where like our services could be for everyone, anyone and everyone?

It'd be so amazing.

We actually have a newborn and postpartum care class that's taught by Jess, that postpartum doula I was mentioning.

And, you know, they do the swaddling, they do the diapering, they do talk about baths and how partners can be helpful with an exclusively breastfeeding parent, because sometimes they can feel really like, I don't know what I'm supposed to do in that situation.

So it's very much a partner class.

And yes, not everybody takes it.

But the ones that do say how much more ready they feel for being able to help.

And I think that people plan so much for their birth and which is, you know, I mean, the other one, the one the other day was like two days long.

So it can be long, but the postpartum period is much longer.

So I wish that more people would put more effort into thinking about that.

So if you're saying you wish it was accessible for everyone and so do we.

So that kind of brings me to a question of, how do people get this?

And is this something that you need to be referred to by another provider?

Is this something that's covered by insurance?

Do you guys even take insurance?

I know you guys are kind of a new niche, so I don't know if that's even a thing yet for y'all.

These are all very, very good questions.

So right now we are out of network, but we do offer super bills.

So that is the document that you can take back to your insurance to potentially get reimbursed.

And I would say since we are, what is it called?

Preventative and wellness, we are not covered by insurance.

And I don't think that's the only reason as to why, definitely also because insurance is also driven by research.

You know, like what are the numbers showing?

And because we are so niche and this is still a new emerging practice, there's not much research out there.

So it's kind of like chicken and the egg.

But we're also working on some studies right now to get evidence that what we're doing is helpful and matters and is effective.

So that'll come down the line.

You don't need a referral to come see us because we are preventative in wellness and in the state of Texas, it's not required to have a referral for our type of services in this way.

If we identify an issue that requires more medical intervention or things like that, then we may ask the patient to go back and get a referral from their OB or the dentist or the pediatrician.

And sometimes we do that anyway, just because it helps with reimbursement, but it's super easy.

We'll just send over effects to the potential referring provider.

That seems so weird to me that it is considered preventative and wellness, because sometimes it is not preventative.

Like I would bet a lot of times it's not preventative.

You're coming in because there's already a problem.

Not many people set up their space without already having had some sort of issue going on.

Am I wrong?

You're not wrong, but I would say they don't have an official diagnosis.

So that's where the insurance piece comes in, right?

It's like, if you have a diagnosis and it says, postpartum depression or postpartum anxiety, okay, yes, we'll take a referral for that.

That's great.

But if you are questioning whether you have these issues, like I had a client who was concerned that she might have postpartum rage because she had it in her family.

So we worked with her and we screened to make sure, does she need to go and see a therapist or a psychiatrist?

And it turns out she was just doing all the things.

She was going back to nursing school.

She'd just become a mom.

She was going back to work.

So I was like, okay, let's kind of rein that in and we'll work through it.

And so we did the day-to-day schedule and things for that.

But to go back and answer your question, there's not always a diagnosis when the patient or the client actually comes to see us.

And so that's why we can go without having a referral.

Fine.

Like I don't like that answer, but fine.

I know, I know.

Because I mean, some people do.

So if somebody does already have a PPA or PPD diagnosis and they're dealing with lactation issues that are also being covered by their insurance or they've had mastitis and they've been having medications for that, are they more like in that situation, are they more likely, do you know, to get, I'm asking you questions totally off of the thing here and you're probably like, she's putting me on the spot.

But do those things tend to get covered more easily because they already do have a diagnosis when they're coming to you?

They can be.

We're still getting word back from some of our clients and what their reimbursement rates are.

They're just not the best.

Unfortunately, occupational therapy is not always reimbursed well.

And you know, reimbursement is like a whole game.

And so we didn't even want to deal with that as we get started because we want to show the value of our work before getting in that game of like reimbursement numbers and stuff like that.

Yeah, we have, you know, we don't take insurance as doulas or for our childbirth education, but we do provide for the people that want it, kind of a super bill, something similar, that people can go and try to get reimbursed with their insurance.

And we've even had quite a few people now reach out to us and ask us to fill out a form for something called Carrot, which is like through their employment and all of that.

And it's been really cool because they're getting reimbursed.

But yeah, we don't do it from the front end either.

I think we would need to be paid more if we were doing that because of all of the time that it would take for billing.

Time and paperwork and just-

To bill you for me dealing with insurance.

Yeah, the run around, I mean, it's so unfortunate that we have to go through all that.

I will say though, we do take HSA and FSA.

So yeah, I have a client that's like ready to use that part with us, so.

That's awesome.

Especially as we're getting closer to the end of the year when this episode is coming out and you've got some HSA or FSA or whichever one it is that expires, I can't ever remember.

But you can use those dollars for something nice.

So how can people find you if they wanna learn more or get services with you?

Yes, our website is momsot.com, momsot.com.

We tried to make that one easy because we know Matrescence is hard.

So I was like, girl, you know, we're not gonna be able to spell that name.

I can barely say it.

I know, exactly.

So you'll have to check the show notes for Instagram, but it's matrescence underscore OT.

So the girl with Empowered Beginnings, atx.com as her email or her website.

I'm like, what was I thinking?

We're all doing our best here.

It's fun.

It's fine.

Well, thank you, Gayle, for coming on.

This was awesome.

And I can't wait to share this with people.

Thank you so much.

I really enjoy all the work that you all do.

And thanks for having me on.

Thank you.

Thank you for joining us on Birth, Baby!

Thanks again to Longing for Orpheus for our music.

You can look him up on Spotify.

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